Mortality in second and third degree malnutrition. 1956.
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Biomedical subjects
Publications and source records attributed to S Frenk.
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The safety and efficacy of a rice-based oral rehydration salt (ORS) solution for the treatment of acute diarrhea in infants < 6 months of age was compared to those of a standard glucose-based ORS solution. A total of 97 infants aged 1-6 months who had a history of acute diarrhea for 120 h or less and showed signs of mild to moderate dehydration and no complications was recruited. Subjects were assigned to two treatment groups and received either standard glucose-based ORS solution or rice-based ORS solution until cessation of diarrhea. There was no significant difference between the two treatment groups with regard to the main outcome variables, including total stool output (84 [95% confidence interval (CI), 56-126] vs. 106 (95% CI, 76-148) g/kg], total ORS solution intake [171 (95% CI, 149-197) vs. 187 (95% CI, 161-218) ml/kg], or duration of diarrhea (35 +/- 31 vs 38 +/- 32 h). In addition, the fact that there was no difference between treatment groups in the presence of reducing substances in the stools suggests that rice was digested and absorbed by these infants. The results of our study support the conclusion that for infants < 6 months of age, rice-based ORS solution is safe and as efficacious as standard glucose-based ORS solution in the treatment of acute diarrhea.
Today, the long-chain polyunsaturated fatty acids, omega 6 and omega 3, are of special interest to different research groups, all over the world, due to its physiological and metabolic importance. This paper presents different cases of fatty acids deficiency from which the cases of premature low-birth-weight neonates and children under 5 years old presenting severe malnutrition, stand out. In addition, various inherited pathological processes that involve the mechanism of oxidation of these nutrients, are also described.
The polyunsaturated fatty acids, omega 6 and omega 3, are organic compounds that have to do with the daily caloric intake; the tissue deposits of energy reserve, as well as the general intermediary metabolism of the human organisms and the composition of all the cellular membranes. This article is about its general characteristics: chemical structure, essenciality, biosynthesis, and physiological and metabolical functions; its compounds and metabolites derived; its organic distribution, and the quantity found in food in general. Of all these, special emphasis are made on the essenciality of linoleic and alpha-linolenic acids, due to its metabolic importance.
The oligo-elements or trace elements have acquired a major importance in the knowledge concerning corporal composition and in the comprehension of their metabolic participation in organic processes. Today, thanks to the technological and scientific progress reached by modern pediatrics, the studies made at cellular level have advanced to a molecular level, which will in the future be, without doubt, the bridge that will lead into the atomic level. In addition, this review will briefly summarize several facts of the knowledge accumulated up to now, regarding: 1. The nutritional aspects of these oligo-elements; 2. Its biological functions in healthy condition, especially in children; 3. Their respective nutritional requirements.
In the last 3 decades, the discovery of importance of trace elements in structure and functions of many enzymes, provided a tremendous impetus for research on the physiopathology, metabolism, clinical pharmacology and toxicology of these micronutrients in human beings, specially, in children. This paper presents recent information on various pathological inherited and acquired conditions, with abnormal nutritional status in children, due either to deficiency or excess of some oligo-elements. The general aspects of abnormal metabolism, physiopathology, and some specific clinical features, are described.
The metabolic response to chronic undernutrition covers a wide spectrum that ranges from decreased growth velocity in mild cases to profound distortion of body silhouette and composition and functional derangements in advanced stages of the protein-energy malnutrition-infection complex. A wide gamut of molecular, enzymatic, and hormonal processes assure a temporary availability of endogenous nutrients and the maintenance of vital functions.
The case of a 13-year-old boy with the advanced clinical picture of the idiopathic DeToni-Debré-Fanconi syndrome is described, on whom acute studies of proximal tubular functions and of the effect of furosemide thereon were performed. Sodium bicarbonate loading corrected the hyperchloremic acidosis, but induced an increase of urinary bicarbonate loss of over 20% of the filtered amount. Furosemide corrected bicarbonate reabsorption in spite of the presence of metabolic alkalosis. The urinary excretion of alpha-amino nitrogen, glucose, and phosphates decreased and tubular reabsorption of the two latter increased under furosemide. On a chronic treatment with furosemide and dietary sodium chloride restriction, correction of hyperchloremic acidosis, hypophosphatemia and rickets was achieved.
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Protein quality of a lactose-free milk (LFM) was compared with a soy-protein isolate (SPI) by means of the PER and 24-hour nitrogen balance methods performed with 16 infants with protein-energy malnutrition. PER was 1.19 for the SPI, value which is significantly lower than that of 2.28 obtained for LFM, and 2.71 for casein. Nitrogen absorption of LFM and SPI was 80%. The biological value of both formulas did not differ significantly; however, in six month-old babies or younger with severe malnutrition, nitrogen retention was higher with LFM than with SPI. On the other hand, nitrogen retention was higher in infants 11 and 12 months old with moderate malnutrition fed the SPI formula. The results suggest that both formulas are good alternatives for the treatment of infants with protein-energy malnutrition and lactose intolerance.
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